Immunosenescence and vaccination in nursing home residents

Through the proposed study, we will learn about the role of clinical interventions, particularly vitamin D, to improve the immune response to infection and vaccines, and ultimately reduce the incidence and severity of infection in older adults.

Figure 1 Flow diagram illustrating the relationship between immunosenescence and vaccination in nursing home patients Figure 1 View large Download slide Flow diagram illustrating the relationship between immunosenescence and vaccination in nursing home patients Longitudinal studies may help to elucidate some aspects of the complex interaction between aging and chronic diseases [ 2930 ].

These elderly individuals are very different from healthy, community-dwelling elderly individuals, in that many are considered to be frail and have various chronic diseases. PHLP cannot provide legal advice on any issue and cannot represent any individual or entity in any matter.

The co-mentor for immunology, Myron Levin, MD, is Professor of Medicine and Pediatrics at UCD, whose research has focused on characterizing and improving response to influenza and herpes zoster vaccines. So, we asked if the high-dose vaccine also would work better than regular-dose vaccine in the population we consider least able to respond.

In this article, we review the immunological changes commonly found in nursing home residents and summarize vaccine efficacy studies involving elderly nursing home residents. The serum IL-6 levels correlated inversely with a protective vaccine response, measured by anti-hemagglutinin HA titer.

In contrast, immune responses to purified antigens ie, protein, polysaccharide, glycoconjugate, and inactivated microbes are more fleeting as they are rapidly cleared from the vaccination site.

Therefore, it is important to take secondary age-related effects, attributable to factors such as chronic diseases, inflammation, frailty, nutrition, functional status, and stress, into account when assessing vaccination strategies.

Additional Infection Risk Factors for Elderly Nursing Home Residents Nursing home residents are at additional risk merely by being in the nursing home environment.

In contrast to the T cell-dependent response, this response is rapid, transient 1 week longproduces low-affinity antibodies, and does not result in a memory response. A recent study involving nursing home residents found that subjects with low zinc concentrations had a lower incidence of pneumonia, a shorter duration of pneumonia, and fewer days of antibiotic use than did those with normal final serum zinc concentrations [ 18 ].

This implies age at primary vaccination is a more important determinant of proper memory T cell function, rather than age at recall response. Another micronutrient receiving increased attention for its role in host defenses is vitamin D.

However, there was insufficient power to actually demonstrate an effect. The immune system is part of the larger neuroimmune-endocrine system; most known hormones have immunomodulatory effects [ 22 ]. Two separate studies have shown that using a 2. As a result, they are also more likely to experience more severe influenza-related complications.

An inflammatory response is also required to increase co-stimulatory molecule expression that is needed to activate T and B cells. The study compared hospitalization rates among more than 38, residents of nursing homes in 38 states during the flu season based on Medicare claims data.

In order to circumvent this short-lived response, polysaccharide vaccines are conjugated to immunogenic carrier proteins ie, tetanus and diphtheria toxoids to elicit a T cell-dependent B cell response.

This prevents the expansion of T cell clones with other specificities due to limited space in the T cell repertoire.

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A small fraction of B cells, now memory B cells, will migrate to long-term survival niches such as the bone marrow where they continue to undergo affinity maturation for 4—6 months, increasing their antibody affinity.

among nursing home residents. 1,2 Vaccination guidelines from the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and. Menu of State Long-Term Care Facility Influenza Vaccination Laws. Format North Carolina law requires nursing home residents to be vaccinated for influenza but.

Immunosenescence and Vaccination. in Nursing Home Residents Immunosenescence is the scientific term for the aging of a human beings immune system.

Immunosenescence in the nursing home Immunosenescence and vaccination in nursing home residents. Mao Y, Li J: An association between immunosenescence and. Loeb M.